Clinic
Midwest Mobile Dentistry LLC
Midwest Mobile Dentistry LLC was paid $184K by Medicaid between Jan 2018 and Feb 2019, across 11 billing codes. Its largest line is D9410, — 43% of everything it billed.
33Billing provider infoMIDWEST MOBILE DENTISTRY LLC
SAINT LOUIS, MO 63105
SAINT LOUIS, MO 63105
33aNPI1417477985assigned 06/26/2017
33bProvider typeDental Clinic/Center
28Total paid$184K
24GClaims6,090
24DCodes billed11
24AFirst – last monthJan 2018 – Feb 2019
Compared with peers
Next to other Dental Clinic/Center providers in Missouri
Rank by total paid#6 of 27
Median peer was paid$9K
This provider vs. median20×
Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 4,880 | $143K | |
| 2019 | 1,210 | $42K |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| D9410 | 43% | 1,229 | 1,207 | $80K | |
| D9310 | 25% | 1,228 | 1,208 | $45K | |
| D4355 | 13% | 445 | 436 | $25K | |
| D1110 | Prophylaxis - adult | 6.6% | 456 | 447 | $12K |
| D0230 | Intraoral - periapical each additional radiographic image | 6.3% | 1,588 | 417 | $12K |
| D1208 | Topical application of fluoride, excluding varnish | 2.6% | 447 | 438 | $5K |
| D0220 | Intraoral - periapical first radiographic image | 2.1% | 438 | 430 | $4K |
| D7140 | Extraction, erupted tooth or exposed root | 1.2% | 44 | 14 | $2K |
| D0150 | Comprehensive oral evaluation - new or established patient | <1% | 90 | 90 | $154.00 |
| D0120 | Dental checkup, returning patientPeriodic oral evaluation - established patient | <1% | 89 | 88 | $24.00 |
| D0170 | 0% | 36 | 36 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.
From NPPES
Who's on the registration
Authorized officialGRAHAM, JEREMY (OWNER/CEO)